The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) was formed in response to the needs of the unabated domestic HIV epidemic in youth. The Adolescent Medicine Leadership Group (AMLG) and ATN Coordinating Center (ACC) described in this application propose to continue to build on their scientific, administrative and experiential leadership of the ATN and together with the site personnel develop and implement the scientific agenda of the ATN for this next project period. The scientific and administrative leadership proposed here will continue to work toward maximizing quality, efficiency and productivity while incorporating responsiveness, flexibility, transparency and innovation in their work. Additionally, the ATN as a whole will continue to nurture and expand the collaborations that were established in the first two project periods with other federally funded networks and programs. The proposed ACC will continue its pivotal facilitating role in the functioning of the ATN. The AMLG is comprised of three distinct scientific leadership groups, the Behavioral (BLG), Community Prevention (CPLG) and Therapeutic Leadership Groups (TLG), with complimentary expertise both within and across groups to provide the multidisciplinary approach needed to address issues in the populations of focus. The BLG has initially prioritized engaging and retaining HIV+ youth in care, secondary prevention/risk reduction, integrated treatment approaches, and neurocognitive implications of HIV among youth. The CPLG will focus on sustaining the community based infrastructure established in ATN I and II and adding interventions and biomedical components focusing on primary prevention. The TLG will initially focus on antiretroviral management strategies, metabolic and cardiovascular disease in the context of HIV, prevention of co-infections, pharmacokinetic studies, and behavioral interventions to reduce health impacts of HIV. The scientific agenda of the leadership groups will be continually reviewed in the context of future developments and a flexible, adaptive approach to address new challenges and opportunities will continue to be a priority. RELEVANCE: The ATN as a whole remains the only federally funded network focused solely on the complex needs and issues of the HIV infected and at-risk youth at the epicenter of the domestic HIV epidemic. The scientific agenda of the ATN is broad and includes testing strategies and approaches for HIV prevention, for managing HIV in youth, and for enhancing life decisions and health outcomes in HIV-infected youth.